Huang Lili, Qin Chuanqi, Wang Li, Zhang Tiejun, Li Jianguo
Department of Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei 430079, P.R. China.
Oncol Lett. 2021 Feb;21(2):106. doi: 10.3892/ol.2020.12367. Epub 2020 Dec 10.
Oral cancer is one of the most common malignancies in the world. The present study aimed to investigate the effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer. Patients were randomly divided into the dexmedetomidine and control groups. Within 15 min before anesthesia induction, dexmedetomidine was infused with a 0.5 µg·kg loading dose followed by a maintenance dose of 0.4 µg·kg·h to the end of operation in the dexmedetomidine group, whereas the same volume of saline was administered in the control group. Blood samples were obtained at five time-points: 30 min Before induction (T), 1 h after induction (T), end of the operation (T) and 24 (T) and 48 h (T) after the operation. The T lymphocyte subsets (including CD3, CD4 and CD8 cells) and CD4/CD8 ratio, B lymphocytes, dendritic cells and myeloid-derived suppressor cells (MDSCs) were analyzed by flow cytometry. All immunological indicators, except CD8 cells, significantly decreased between the two groups at T compared with T (P<0.05). The percentages of CD3, CD4, dendritic cells and the CD4/CD8 ratios were significantly higher at T and the percentages of MDSCs were significantly lower at T in the dexmedetomidine group compared with the control group (all P<0.05). These findings suggested that dexmedetomidine can attenuate immunosuppression in patients undergoing radical and reconstructive surgery for oral cancer.
口腔癌是世界上最常见的恶性肿瘤之一。本研究旨在探讨右美托咪定对口腔癌根治及重建手术患者免疫反应的影响。患者被随机分为右美托咪定组和对照组。在麻醉诱导前15分钟内,右美托咪定组给予0.5μg·kg的负荷剂量,随后以0.4μg·kg·h的维持剂量输注至手术结束,而对照组给予相同体积的生理盐水。在五个时间点采集血样:诱导前30分钟(T₀)、诱导后1小时(T₁)、手术结束时(T₂)以及术后24小时(T₃)和48小时(T₄)。通过流式细胞术分析T淋巴细胞亚群(包括CD3、CD4和CD8细胞)以及CD4/CD8比值、B淋巴细胞、树突状细胞和髓源性抑制细胞(MDSCs)。与T₀相比,两组在T₁时除CD8细胞外的所有免疫指标均显著下降(P<0.05)。与对照组相比,右美托咪定组在T₁时CD3、CD4、树突状细胞的百分比以及CD4/CD8比值显著更高,而MDSCs的百分比在T₁时显著更低(均P<0.05)。这些发现表明,右美托咪定可减轻口腔癌根治及重建手术患者的免疫抑制。